Podcast
Questions and Answers
What is the minimum duration of combined estrogen/progestogen therapy that increases the risk of breast cancer?
What is the minimum duration of combined estrogen/progestogen therapy that increases the risk of breast cancer?
Why is progestogen prescribed in addition to estrogen in women with a uterus?
Why is progestogen prescribed in addition to estrogen in women with a uterus?
What is the most effective treatment for hot flashes according to the passage?
What is the most effective treatment for hot flashes according to the passage?
What is the recommended prescription practice for hormone therapy in women with a uterus?
What is the recommended prescription practice for hormone therapy in women with a uterus?
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What alternative therapy has been shown to have a modest improvement in hot flashes and vaginal dryness?
What alternative therapy has been shown to have a modest improvement in hot flashes and vaginal dryness?
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What is the benefit of using a combined formulation of estrogen and bazedoxifene?
What is the benefit of using a combined formulation of estrogen and bazedoxifene?
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What therapy has been shown to significantly reduce hot flashes according to small studies?
What therapy has been shown to significantly reduce hot flashes according to small studies?
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What is the consensus on the effectiveness of alternative therapies such as yoga, paced respiration, and acupuncture in treating menopausal symptoms?
What is the consensus on the effectiveness of alternative therapies such as yoga, paced respiration, and acupuncture in treating menopausal symptoms?
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What is the primary concern when using progestogens in patients?
What is the primary concern when using progestogens in patients?
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Which of the following is a contraindication for Duavee?
Which of the following is a contraindication for Duavee?
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What is the benefit of using bazedoxifene in combination with estrogen?
What is the benefit of using bazedoxifene in combination with estrogen?
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What is the purpose of titrating clonidine dosage from a lower level?
What is the purpose of titrating clonidine dosage from a lower level?
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What is the current status of stellate ganglion block for menopausal symptoms?
What is the current status of stellate ganglion block for menopausal symptoms?
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What is the potential limitation of using clonidine for menopausal symptoms?
What is the potential limitation of using clonidine for menopausal symptoms?
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What percentage of women are affected by genitourinary syndrome of menopause?
What percentage of women are affected by genitourinary syndrome of menopause?
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What is the recommended age for discontinuing oral contraceptives when transitioning to hormone therapy?
What is the recommended age for discontinuing oral contraceptives when transitioning to hormone therapy?
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What is the main reason for measuring follicle-stimulating hormone levels after stopping oral contraceptives?
What is the main reason for measuring follicle-stimulating hormone levels after stopping oral contraceptives?
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What is the most common adverse effect of ospemifene?
What is the most common adverse effect of ospemifene?
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What is the recommended treatment for women with genitourinary syndrome of menopause who do not respond to nonhormonal medications?
What is the recommended treatment for women with genitourinary syndrome of menopause who do not respond to nonhormonal medications?
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What is the key factor in choosing an estrogen formulation for genital atrophy?
What is the key factor in choosing an estrogen formulation for genital atrophy?
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What is the primary indication for ospemifene?
What is the primary indication for ospemifene?
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What is the conclusion regarding the risk of breast cancer recurrence with the use of low-dose local estrogen?
What is the conclusion regarding the risk of breast cancer recurrence with the use of low-dose local estrogen?
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What is the contraindication for using ospemifene in women with a history of?
What is the contraindication for using ospemifene in women with a history of?
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Who is the chair of the Department of Obstetrics and Gynecology?
Who is the chair of the Department of Obstetrics and Gynecology?
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What is the name of the database used in the evidence-based search?
What is the name of the database used in the evidence-based search?
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What is the name of the journal that published the article by Johnson and Hauck in 2016?
What is the name of the journal that published the article by Johnson and Hauck in 2016?
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What is the name of the study that investigated the endometrial effects of a tissue-selective estrogen complex?
What is the name of the study that investigated the endometrial effects of a tissue-selective estrogen complex?
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What is the name of the review that updates previous articles on this topic?
What is the name of the review that updates previous articles on this topic?
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What is the name of the institution that conducted the professional search?
What is the name of the institution that conducted the professional search?
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What is the focus of the study by Goletiani et al?
What is the focus of the study by Goletiani et al?
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What is the title of the journal where Dr. Crider is an assistant professor?
What is the title of the journal where Dr. Crider is an assistant professor?
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What is the title of the article where Dr. Hill is mentioned as an author?
What is the title of the article where Dr. Hill is mentioned as an author?
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What is the title of the journal where Dr. Hill's correspondence address is mentioned?
What is the title of the journal where Dr. Hill's correspondence address is mentioned?
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What is the title of the study where omega-3 is mentioned as a treatment for vasomotor symptoms?
What is the title of the study where omega-3 is mentioned as a treatment for vasomotor symptoms?
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What is the title of the journal where Dr. Loprinzi is an author?
What is the title of the journal where Dr. Loprinzi is an author?
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What is the title of the article where Dr. Cohen is mentioned as an author?
What is the title of the article where Dr. Cohen is mentioned as an author?
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What is the title of the study where plant-based therapies are mentioned for menopausal symptoms?
What is the title of the study where plant-based therapies are mentioned for menopausal symptoms?
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What is the title of the journal where Dr. Kaunitz is an author?
What is the title of the journal where Dr. Kaunitz is an author?
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Study Notes
Hormone Therapy and Menopause
- Hormone therapy was previously prescribed to improve overall health and prevent cardiac disease, as well as for symptoms of menopause.
- Combined estrogen/progestogen therapy increases the risk of breast cancer when used for more than three to five years.
- Estrogen alone is not associated with an increased risk of breast cancer.
- In women with a uterus, combination therapy should only be used to treat menopausal symptoms like hot flashes and vaginal atrophy, using the smallest effective dosage for the shortest possible duration.
Nonhormonal Alternatives
- Low-dose paroxetine, venlafaxine, and gabapentin are effective alternatives to estrogen for treating hot flashes.
- Women with a uterus who are using estrogen should also take a progestogen to reduce the risk of endometrial cancer.
- A combined formulation of estrogen and the selective estrogen receptor modulator bazedoxifene may be beneficial for women who cannot tolerate progestogens.
Other Treatment Options
- There is no high-quality, consistent evidence that yoga, paced respiration, acupuncture, exercise, stress reduction, relaxation therapy, and alternative therapies are more effective than placebo.
- Soy products may provide modest improvement in hot flashes and vaginal dryness.
- Clinical hypnosis may significantly reduce hot flashes.
- Clonidine is somewhat more effective than placebo but has adverse effects like hypotension, dizziness, and rebound hypertension.
Genitourinary Syndrome of Menopause
- Genitourinary syndrome of menopause refers to bothersome genital symptoms from changes in the vulva, vagina, and lower genital tract caused by diminished estrogen.
- Up to one-half of women during menopause are affected by this condition.
- Low-dose vaginal estrogen is an effective treatment for mild vaginal dryness and related dyspareunia.
- Ospemifene is the only FDA-approved nonhormonal therapy for dyspareunia caused by menopausal atrophy.
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Description
Learn about hormone therapy and its effects on menopause, including the increased risk of breast cancer and treatment of menopausal symptoms.
